A Web-Based Recovery Program (ICUTogether) for Intensive Care Survivors: Protocol for a Randomized Controlled Trial (Preprint)

Abstract

Background: Those who experience a critical illness/event requiring admission to an intensive care unit frequently experience physical and psychological complications as a direct result of their critical illness/event and intensive care unit experience. Complications, if left untreated, can affect the quality of life of survivors and impact upon health care resources. Explorations of potential interventions to reduce the negative impact of an intensive care unit experience have failed to establish an evidence based intervention. The aim of this study is to evaluate the impact of a web based intensive care recovery program on the mental well-being of intensive care survivors and to determine if it is a cost effective approach. Methods:One hundred and sixty-two patients that survived an intensive care unit experience will be recruited and randomized into one of two groups. The intervention group will receive access to the web based intensive care recovery program, ICUTogether, two weeks after discharge (n=81) and the control group will receive usual care (n=81). Mental well-being will be measured using the Hospital Anxiety and Depression Scale, The Impact of Events Scale-Revised and the EQ-5D at three time points (2 weeks, 6 months and 12 months post discharge). Analysis will be conducted on an intention to treat basis using regression modelling. Covariates will include baseline outcome measures, study allocation (intervention or control), age, gender, length of intensive care unit stay, Apache III score, level of family support and hospital readmissions. Participants' evaluation of the mobile website will be sought at 12 months post discharge.A cost utility analysis conducted at 12 months from a societal perspective will consider costs incurred by individuals as well as health care providers.Discussion: This study will evaluate a novel intervention in a group of intensive care unit survivors. The findings from this study will inform a larger study and the wider debate about an appropriate intervention in this population.